1994～2004年泰安市城区饮食服务业从业人员查体资料分析

[目的]了解饮食服务业从业人员病毒性肝炎、伤寒、痢疾、肺结核及皮肤病（“五病”）感染状况，进一步加强对饮食服务业从业人员的健康管理。[方法]对泰安市城区直接管辖的饮食服务业从业人员1994～2004年查体资料进行分析。[结果]1994～2004年合计检查183532人，“五病”检出率为3．15％，呈逐年下降趋势；HBsAg阳性率为2．18％，伤寒检出率为0．27／万，细菌性痢疾检出率为0．03％，肺结核患病率为0．07％，皮肤病（手癣、指甲癣、手部湿疹、银屑或鳞屑病、化脓性皮肤病、渗出性皮肤病）患病率为0．87％。[结论]“五病”检出率呈逐年下降趋势，但乙肝病毒感染率仍然较高。     

中国成年居民营养补充剂的消费现状

目的:分析我国成年居民使用营养补充剂的现状,为有针对性地制定干预策略和相关政策提供基础资料。方法:使用2002年中国居民营养与健康状况调查数据,对53159名18岁及以上居民的营养补充剂使用率及其中钙制品、铁剂、维生素和其他保健食品的使用率进行分析。结果:我国18岁及以上居民营养补充剂的使用率为5.1%,其中钙制品、铁剂、维生素和其他保健食品的使用率分别为3.4%、1.3%、2.4%和2.2%。营养补充剂的使用率表现为城市高于农村,女性高于男性,60岁及以上年龄组、45-59岁年龄组、18-44岁年龄组使用率依次降低。结论:我国成年居民中使用营养补充剂尚不普遍。     

基于血糖负荷概念的食物交换份在糖尿病营养治疗中的应用

目的:建立以控制血糖负荷和总能量为特征,体现食物血糖应答差异的新型食物交换系统,探索其在糖尿病人饮食管理中的应用价值。方法:根据食物血糖指数(glycemicindex,GI)与碳水化物含量计算血糖负荷(glycemicload,GL),比较GI与GL的相关性以及对食物血糖效应的影响。融合GL和食物交换份方法的特点,提出基于GL的新型食物交换份。结果:粮谷类、豆类及制品的GI与GL%有较好的一致性,相关系数分别为0.64、0.55。而蔬菜、水果类食物的GI与GL%无明显相关性。基于GL的食物交换份既保留了传统交换方法简单易行的特点,又充分考虑了碳水化物在质和量方面的差异,有助于在控制总能量的同时,定量预测或调整混合膳食的血糖应答效应。结论:基于GL的食物交换份有较高的应用前景,值得实践和推广。     

浅析医疗机构中志愿者体系的管理和发展

医疗志愿者体系发展至今，在国外已有相当的规模和管理机制，但是对于国内的医疗机构来说，仍在不断的探索中。本文将结合复旦大学附属儿科医院于2002年6月1日成立的首批“阳光爱心”志愿者队伍的情况，探究志愿者体系在医疗机构中的管理和发展。     

Critical management in patients with severe enterovirus 71 infection

OBJECTIVE: The aim of this study was to analyze clinical details occurring in children with severe enterovirus 71 (EV71) infection and synthesize the critical care experience for patients with severe EV71 infection. METHODS: A retrospective clinical, laboratory, and hemodynamic study was performed in a pediatric intensive care unit in a university hospital. From March 1998 to April 2000, seven consecutive pediatric patients with severe EV71 infection were retrospectively analyzed as the comparison group. From May 2000 to March 2003, eight consecutive patients with severe EV71 infection who had received the protocol therapy were enrolled as the study group. Detailed information about clinical treatment and pharmacological therapy was collected for comparison. RESULTS: The clinical presentations and laboratory findings between the comparison and the study groups were not significantly different. The amount of intravenous fluid in the first 24 h was significantly higher in the comparison group (9.2+/-5.0 vs 4.9+/-1.3 mL/kg per h). More patients in the study group received low doses of dopamine infusion, patients in the comparison group received more epinephrine, and none of them received milrinone. The acute-stage and long-term survival rates were higher in the study group (100% vs 43%, 87% vs 29%). CONCLUSION: Early cardiopulmonary support may prevent the vicious cycle of cardiopulmonary failure and improve the clinical outcome of severe EV71 infection. Milrinone may be the ideal inotropic agent for these patients. Echocardiography, a central line, and an arterial line could be an alternate method to replace direct intracardiac hemodynamic monitoring for guiding critical management.     

Effect of a structured asthma education program on hospitalized asthmatic children: A randomized controlled study

BACKGROUND: The aim of this study was to compare the effectiveness of an intensive asthma education program (group B) with that of a standard asthma education program (group A). METHODS: A prospective randomized single blinded study was conducted in the pediatric department of a public hospital in Hong Kong. Children aged 2-15 years admitted to the pediatric department with an acute attack of asthma were recruited. A standard asthma education program (group A) or an intensive asthma education program (group B) for children were offered. The main outcome measures include the number of visits to the emergency department and the number of hospitalization for asthma during the 3 month follow-up period. RESULTS: A total of 45 children were in group A and 55 in group B. Group B had statistically significant reductions in the number of visits to the emergency department and the number of hospitalizations. Drug compliance was also significantly improved in group B. Parents' satisfaction rate was also higher in group B. CONCLUSION: The intensive asthma education program might be more cost effective than the standard asthma education program in the management of asthmatic children admitted to hospital in Hong Kong.     

医改与政府责任的伦理思考

在归纳医改失败原因的主流性意见和分析典型案例的基础上,揭示：医改失败的根本原因是趋利性临床决策和泛企业化卫生政策,形成机制是二者的共同作用,实质是医疗卫生服务与广大人民群众日益增长的健康需求和经济发展水平的不相适应,其中折射出政府责任伦理主要方面的缺位、不到位和不作为;医疗卫生服务的基本目标是社会公众利益的最大化,这是医疗卫生服务领域中始终应占主导地位的价值取向,当然也是医改中政府责任伦理的正确取向.     

信息时代实施个人知识管理的思考

信息时代,面对海量的信息和繁多的信息渠道,如何有效获取信息、吸收信息和运用信息成为每个人所必须面对的问题。个人知识管理作为知识管理思想在个人层面的应用为解决这个问题提供了思路和方法。文章就信息时代个人如何实施知识管理做了探讨,总结了个人知识管理的实施框架、详细阐述了个人知识管理的实施过程和所需技能,并对个人知识管理系统的发展做了分析。     

如何利用Blackboard教学管理系统构建生理学网络课程

B lackboard教学管理系统可为教师创建、发布和管理网络课程提供方便、快捷的工具模块。文章介绍了如何利用B lackboard教学管理系统提供的课程内容模块、测验模块和课程工具模块来构建生理学网络课程的过程。指出生理学网络课程的建设,对突破传统面授教学的局限性和帮助学生网上学习具有重要意义。     

曲靖市某磷酸盐厂"三废"中的氟对周围人群健康的影响

目的了解曲靖市某磷酸盐厂排出“三废”中的氟对周围人群影响情况。方法当地疾病控制与监督部门于1998年对该厂周围的虹桥、耿屯、望城、螃蟹坡4个村人群进行随机抽样调查。结果尿氟>3 mg/L检出率分别为1.72%、23.44%、33.33%,16.13%。发现低年龄组患氟斑牙比较严重,4个村检出率分别为45.16%、64.52%、72.73%、81.25%,而高年龄组患氟骨症比较明显。结论有关部门必须加强对该厂废气排放的管理。